"Triglycerides: Why do they matter?
High triglycerides are link to heart disease.
Triglycerides are fat or lipid
Food eaten are converted into calories. Unused calories are converted into triglycerides and stored
in fat cells for future energy need. These stored triglycerides are released by hormones as needed energy between meals. When
more calories (food) are eaten than needed, specially carbohydrates and fats, one may develop high blood triglycerides (hypertriglyceridemia).
Normal — Less than 150 milligrams per deciliter (mg/dL), or less than
1.7 millimoles per L (mmol/L)
Borderline high — 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
High — 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
Very high — 500 mg/dL or above (5.7 mmol/L or above)
Optimal by The American Heart Association (AHA)
100 mg/dL (1.3 mmol/L) or lower
achieved by lifestyle modification such as diet, weight loss and physical activity.
Triglycerides and cholesterol
1. Fat or lipid.................................Different
type of fat or lippid
2.Stored unused calories..............Used to build cells and certain hormones.
used as future body energy
As fat both groups of fat can't dissolve in blood, so they are transported throughout body with
the help of proteins (lipoproteins).
High triglycerides are
link to hardening of the arteries (atherosclerosis) leading to obesity,
too much fat around the waist, metabolic syndrome, high blood pressure/triglycerides/blood sugar, abnormal cholesterol levels, type 2 diabetes, low levels of thyroid hormones (hypothyroidism), liver
or kidney disease, or rare genetic conditions that affect how body converts fat to energy, effect of medications such as beta
blockers, birth control pills, diuretics, steroids and tamoxifen.
a) Eat plant base and low saturated fat
diet which usually takes care of b, c, and d.
b) Lose weight: Even losing 5 to 10 pounds can help lower triglycerides.
reduction. Eat complex carbohydrate from vegetables, avoid sugar from all sources which can increase triglycerides levels
cholesterol: Meats, egg yolks and whole milk products, high in saturated fat.
e) Eat plant based monounsaturated fat found in plants: olive, peanut
and canola oils. Avoid saturated and trans fat.
fatty acids: Sources are mackerel, salmon,
sardines and supplements.
g) Limit alcohol which are high in calories and even small amount can raise triglyceride levels.
at least 30 minutes of physical activity 5-7 days/week.
i) Control diabetes and high blood pressure.
When lifestyle modifications do noy work.
a) Niacin (Niaspan)
b) Fibrates (fenofibrate (Lofibra,
TriCor) and gemfibrozil (Lopid).
c) Pantothenic acid
A pantothenic acid derivative called pantethine has been reported by a number of investigators to have a cholesterol-lowering effect. Pantethine is actually two molecules of pantetheine joined by a disulfide bond (chemical bond between two
molecules of sulfur). In the synthetic pathway of coenzyme A (CoA), pantethine is closer to CoA than pantothenic acid and
is the functional component of CoA and acyl carrier proteins. Several studies found doses of 900 mg of pantethine daily (300
mg three times daily) to be significantly more effective than placebo in lowering total cholesterol and triglyceride levels in the blood of both diabetic and non-diabetic individuals (11). Pantethine was also found to lower cholesterol and triglyceride levels in diabetic patients on hemodialysis without adverse side effects. The fact that pantethine has few side effects was especially attractive for hemodialysis patients
because of the increased risk of drug toxicity in patients with renal (kidney) failure (12). Pantethine is not a vitamin; it is a derivative of pantothenic acid. The decision to use pantethine to treat elevated blood
cholesterol or triglycerides should be made in collaboration with a qualified health care provider who can provide appropriate
Pantothenic acid is available in a variety of foods. Rich sources of pantothenic acid include liver and kidney,
yeast, egg yolk, and broccoli. Fish, shellfish, chicken, milk, yogurt, legumes, mushrooms, avocado, and sweet potatoes are
also good sources. Whole grains are good sources of pantothenic acid, but processing and refining grains may result in a 35%
to 75% loss. Freezing and canning of foods result in similar losses (8). Large national, nutritional surveys were unable to estimate pantothenic acid intake due to the scarcity of data on the pantothenic
acid content of food. Smaller studies estimate average daily intakes of pantothenic acid to be from 5 to 6 mg/day in adults.
The table below lists some rich sources of pantothenic acid along with their content in milligrams (mg). For more information
on the nutrient content of foods, search the USDA food composition database.
||Pantothenic Acid (mg)|
|Fish, cod (cooked)
|Tuna (light, canned in water)
||1 cup (8 ounces)
||1/2 cup (chopped)
|Split peas (cooked)
|Sweet potato (cooked)
||1 medium (1/2 cup)
||1/2 cup (chopped)
|Bread, whole wheat
The bacteria that normally colonize the colon (large intestine) are capable of making their own pantothenic acid. It is not yet known whether humans can absorb the pantothenic
acid synthesized by their own intestinal bacteria in meaningful amounts. However, a specialized process for the uptake of
biotin and pantothenic acid was identified in cultured cells derived from the lining of the colon, suggesting that humans
may be able to absorb pantothenic acid and biotin produced by intestinal bacteria (13).
Supplements commonly contain pantothenol, a more stable alcohol derivative, which is rapidly converted to pantothenic
acid by humans. Calcium and sodium D-pantothenate, the calcium and sodium salts of pantothenic acid, are also available as
Pantethine is used as a cholesterol-lowering agent in Europe and Japan and is available in the U.S. as a dietary
Pantothenic acid is not known to be toxic in humans. The only adverse effect noted was diarrhea resulting from
very high intakes of 10 to 20 grams/day of calcium D-pantothenate (15). However, there is one case report of life-threatening eosinophilic pleuropericardial effusion in an elderly woman who took
a combination of 10 mg/day of biotin and 300 mg/day of pantothenic acid for two months (16). Due to the lack of reports of adverse effects when the Dietary Reference Intakes (DRI) for pantothenic acid were established
in 1998, the Food and Nutrition Board of the Institute of Medicine did not establish a tolerable upper level of intake (UL) for pantothenic acid (8). Pantethine is generally well tolerated in doses up to 1,200 mg/day. However gastrointestinal side effects, such as nausea and heartburn, have been reported (14).
Oral contraceptives (birth control pills) containing estrogen and progestin may increase the requirement for
pantothenic acid (15). Use of pantethine in combination with HMG-CoA reductase inhibitors (statins) or nicotinic acid may produce additive effects
on blood lipids (14).
Linus Pauling Institute Recommendation
Little is known regarding the amount of dietary pantothenic acid required to promote optimal health or prevent
chronic disease. The Linus Pauling Institute supports the recommendation by the Food and Nutrition Board of 5 mg/day of pantothenic
acid for adults. A varied diet should provide enough pantothenic acid for most people. Following the Linus Pauling Institute
recommendation to take a daily multivitamin-mineral supplement, containing 100% of the Daily Value (DV), will ensure an intake of at least 5 mg/day of pantothenic acid.
Older adults (65 years and older)
Presently there is little evidence that older adults differ in their intake or requirement for pantothenic acid.
Most multivitamin/multimineral supplements provide at least 5 mg/day of pantothenic acid.